A pictorial review of the anatomy and common pathology of the buccal space

The head and neck region is divided by fascial planes into a series of compartments. Knowledge of these compartments and their contents limits the daunting gamut of head and neck pathology to a manageable differential diagnosis. The buccal space is one such compartment that has not received an equitable representation in the literature relative to other compartments, primarily because of the predominance of adipose tissue and its small size. However, because of the close relationship to important structures both in and around this space, a variety of pathology may be seen.

A meta-analysis of the literature reveals the most common pathology of the buccal space to be salivary gland tumors, especially pleomorphic adenoma. Other common etiologies of lesions are hemangiomas, 2 infection, and benign and malignant lymph nodes. Patients with buccal space masses usually present with a cheek mass or swelling that is readily apparent and palpable clinically. Although many lesions have nonspecific characteristics on computed tomography (CT) and magnetic resonance imaging (MRI), there are conditions that do have distinctive findings. In general, the lack of specificity of imaging is inconsequential as most lesions are excised, often for cosmetic reasons. This review is intended to enhance the readers’ knowledge of the anatomy (Figure 1) and pathology of this often-overlooked space, thereby facilitating the diagnosis of lesions therein.